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Families of addicts at increased risk of addiction and depression

In the years immediately surrounding the diagnosis, family members of those with alcohol or drug dependence (AODD) are more likely to be diagnosed with substance use disorder, depression and trauma.

These families also made greater demands on the healthcare system and had higher total healthcare costs compared with those with a family member with diabetes or asthma, a study from the US has found.

Much is known about the negative health effects of substance misuse for the individual. This paper set out to explore the morbidity and health costs for family members of those with a substance problem compared with relatives of people with asthma and diabetes.

The authors studied the members of an independent healthcare organisation which provides care for more than 3 million people in Northern California, USA. First, they identified a pool of potential index cases of diabetes, asthma and substance misuse who were diagnosed between 2002 and 2005. Those potential index cases with AODD were matched by age, gender and recent medical costs to index cases with diabetes and asthma. Family members of index cases were then identified, and their case records investigated for morbidity and health-related costs between 2001 and 2005.

Of the 25,464 eligible index cases with AODD, 17,345 were matched to an index diabetes case, 19,930 to an index asthma case and 20,320 to a person without AODD. Many of the AODD cases found matches across all 3 comparison groups. Around 80,000 families of index cases were included in the study.

Although matched across a range of variables, the families of those with AODD tended to have lower incomes than those with other morbidities.

Over the study period, each group of families was more likely to be diagnosed with conditions related to the condition of the index person i.e. diabetes family members were more likely to be diagnosed with diabetes, asthma family members with asthma and substance user family members with substance use disorders.

These results are consistent with the fact that each of these conditions has genetic and environmental components.

Those with a substance using family member were also more likely to be diagnosed with depression and trauma, and had increased healthcare costs and usage compared with other index groups.

Disability and chronic illness of any kind affects the whole family. Having a family member with an alcohol or drug problem may have a negative effect on family functioning and dynamics and is associated with an increased risk of being diagnosed with a substance use disorder, depression, and trauma.

GPs should bear this in mind when managing the families of those with problem substance abuse.

Ray G T, Mertens JR and Weisner C. Family members of people with alcohol or drug dependence: health problems and medical cost compared to family members of people with diabetes and asthma. Addiction 2009; 104: 203-214